HomeMy WebLinkAbout2718 Maroon Ct - Applications/Reroof - 02/21/2012Feb 29 12 02:39p Westers Roofing
Ciof
Fort Collins
9705688448 p.3
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Peilet Stove (must be EPA certified, provide make, model and
manufacturer).
complete all applicable information on the application. Incomplete applications will not be accepted.
Application # Date
For office use only
aired) Value of Construction (labor, materials, profit)
]ob ite Address (req 3 Q r (,. Q6
Phone
P operty, Owner Name Address City/State ZIP
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Address /state Zip Phone
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Applicant Name / [�
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Address City/State Zip Phone
Contractor n � �S � �< < r
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Contractor City of Ft. Collins egT,4 # Are you paying taxes here or by report?. ❑Here Q Report
i sales tax riumberis required byall dacto Are you paying with your trust account? Yes ❑ No
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Is this a residential or commercial project? _( Residential ❑ Commercial
If residential, is it: A!lSingle Family Detached ❑ Condoftownhome (single family attached) 0 Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: 0 Bank ❑ Bar ❑ Church ❑ Hotei/Motel O Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 5o years of age or more? ❑ Yes *LNo If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you will need an asbestos assessment to submit with this application.
Description of work
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list lirknsed ele&cian.
Subcontractors: List the company name or City of FtCOMM icense#
Electrician Plumber Mechanical Roofer Other
I hereby acknowledge that I have read this application and state that the above information is complete and correct. I agree to
comply with all requirements contained herein and city ordinances and state laws regulating building construction. I know that a
permit is not valid until it has been paid and issued.
Applicant: �C�
Print Nam "'j n ��"'J Signature - Date C:;�